阻塞性睡眠呼吸暂停低通气综合征合并2型糖尿病患者体脂分布及血脂水平变化

目的比较阻塞性睡眠呼吸暂停低通气综合征（OSAHS）合并与未合并2型糖尿病（T2DM）两组病例颈围、腰围、腰臀比（WHR）、体重指数（BMI）、不同部位脂肪比、血脂与多导睡眠检测（PSG）结果的变化,探讨两者间的关系。方法对28例OSAHS合并T2DM患者测量身高、体重、颈围、腰围、臀围,计算BMI、WHR；用DXA定量测量全身脂肪比、躯干脂肪比、腹部脂肪比；检测血脂,分别与31例OSAHS未合并T2DM患者作比较分析。结果OSAHS合并T2DM组体重、腰围、WHR、BMI、躯干脂肪比、全身脂肪比、腹部脂肪比均大于未合并T2DM患者（P〈0.05）。与未合并T2DM组比较,OSAHS合并T2DM组总胆固醇、甘油三酯、低密度脂蛋白胆固醇增高（P〈0.05）,高密度脂蛋白胆固醇降低,差异有统计学意义（P〈0.05）。OSAHS合并T2DM组呼吸暂停低通气指数（AHI）更高（P〈0.05）,平均血氧饱和度则低于对照组（P〈0.05）。结论OSAHS患者合并T2DM时,脂肪含量增多,并以腹部脂肪堆积为主。OSAHS合并T2DM患者缺氧程度加重；血脂代谢紊乱更加严重,临床上需积极防治。

The distribution of body fat and the changes of level serum lipid amongst patients with obstructive sleep apnea hypopnea syndrome combined with T_2DM

Objective To compare the changes of neck circumference, waist circumference, waist/hip ratio（WHR）,body mass index（BMI）, fat content of different parts,blood lipid and polysomnography test（PSG）between patient groups of obstructive sleep apnea hypopnea syndrome（OSAHS） combined with and non-combined with T2 DM.Methods To measure above mentioned data in 28 patients with OSAHS and T2 DM and in 31 patients only with OSAHS.To calculate the fat ratios of the whole body,the truncus and the abdomen with DXA method. Results The weight,waist circumference,WHR,BMI,fat ratios of whole body,truncus and abdomen in patients with OSAHS and T2 DMwereallgreater than thoseofthepatients with OSAHS and non-combined T2DM（P〈0.05）.The total cholesterol,triglyceride and low density lipoprotein-cholesterol of the group with OSAHS combined with T2 DM were more（P〈0.05）, the high density lipoprotein-cholesterol were less,the apnea hypopnea index were more,and the MSaO2 were less than that of the control group（P〈0.05）.Conclusion In patients with OSAHS and T2 DM, the accumulation of fat mass is mainly in the abdomen. The anoxia aggravates,metabolic disorders aggravate also, and positive treatment is necessary.